| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $273.88 | $273.88 | $273.88 | |
Aetna
| Professional | $195.21 | $227.26 | $273.88 | |
Cigna
| Facility | $580.00 | $580.00 | $580.00 | |
Cigna
| Professional | $418.68 | $529.41 | $661.78 | |
Medica
| Facility | $274.99 | $329.90 | $534.88 | |
Medica
| Professional | $149.63 | $174.82 | $534.24 | |
Midlands
| Facility | $375.98 | $534.24 | $638.54 | |
Midlands
| Professional | $349.63 | $534.24 | $627.37 | |
Sanford Health Plan
| Professional | $349.28 | $680.35 | $800.42 | |
United
| Professional | $122.37 | $174.82 | $384.60 | |
Wellmark
| Professional | $291.36 | $291.36 | $291.36 |